Buildings & Contents Enquiry Form

Please fill out the quotation form below to the best of your ability and then click 'Submit Button' and we will go into the insurance market, and come back to you with the best deal (We know it is a long form to fill, but it has to be done!. As full disclosure of information in insurance is important)

If you do not like filling forms, and you want advise please telephone 0870 0114158

Main Proposer's Details
Title
Sex
First Name
Last Name
Your Full Address

Address of Building to be Insured if different from above

Post Code
Home Telephone
Best Time of Contact
Work Telephone
Work Fax Number
Mobile Telephone No.
E-mail Address
Date Of Birth
Employment Status
Employers Business
1st Time Home Buyer
Spouse or Partner's Details
Title
First Name
Last Name
Date Of Birth
Employment Status
Employers Business
Present or Previous Cover Details Contents Cover:
Present / Previous Cover
Present / Previous Insurer
Renewal Or Commencement Date
Renewal Premium £
Current Excess £
Number Of Claim Free Years
Buildings Cover:
Present / Previous Cover
Present / Previous Insurer
Sum Insured £
Renewal Or Commencement Date
Renewal Premium £
Current Excess £
Number Of Claim Free Years
Property to be Insured
Full Postcode Of Property to be Insured
Residence
Accommodation
Letting Status
Letting Type if applicable
Total Number of Occupants over the Age of 18 years
Total Number of Occupants Under the Age of 18 years
Any Business Use in your Residence
Any Business Stock Kept in your Residence
Any Business Equipment in your Residence
Approximate Year Property Built
'House' Type
Has the Property been Surveyed
'Flat' Type
If a Flat, is it...
'Other' Type
Property Construction
Roof Type
Number Of Bedrooms
When is Property Unoccupied
Is It a Holiday Home
Is the property Free from Storm/Flood; Subsidence; Landslip; Ground Heave
Is the Property in Good Repair
Is the Property near a River or Quarry
Is the Building Listed
Is your property being repaired and Underpinned

Security Measures
Please answer all questions in this section

As discounts on your Home + Contents Insurance can depend on this information
Door Locks Fitted to BS 3621 (5 Lever Mortice) Final Exit Door
Door Locks Fitted to BS 3621 (5 Lever Mortice) to Other Exit Door
Patio Doors Fitted with Security Locks
Window Security Locks Fitted
Intruder / Burglar Alarm Fitted
Accredited Burglar Alarm / Intruder System Fitted (i.e. NACOSS)
Member of Neighbourhood Watch Scheme
Smoke Alarms Fitted

Claims
Have You Had Any Claims In The Last 5 Years
Claims:Please give dates; type of Loss and amount Claimed .

Convictions

Proposer and anyone living in the residence ever declined insurance
Proposer and anyone living in the residence ever been bankrupt
Proposer and anyone living in the residence have any convictionsions or Pending

INSURANCE COVER REQUIRED
Buildings Insurance:
Type of Buildings Insurance Required
State if Voluntary Excess Required £
State Value of Building to be Insured

Contents Insurance:
Type of Contents Insurance Required
Total Value Of Household Contents to be Insured
Total Value Of Household Contents to be Insured
ALL RISKS INSURANCE

(If you have chosen 'All Risks' option part of your Contents Insurance
please fill details below as 'Unspecified Items and 'Specified Items')
Unspecified Items:
Unspecified Valuables
Unspecified Photographic Equipment
Unspecified Sports Equipment
Unspecified Money
Unspecified Credit Cards
Unspecified Freezer Contents Max. Age of Freezer Contents
Unspecified Furnishings
Unspecified Clothing
Unspecified Personal Effects
Unspecified Bicycles (State Number of Bicycles: Value: Make: and Model
If you have chosen 'All Risks' List Specified Items (Value of each item over £1000 Including V.A.T.)
Specified Item with Value over £1000 incl. V.A.T) Value £
Specified Item with Value over £1000 incl. V.A.T) Value £
Specified Item with Value over £1000 incl. V.A.T) Value £
Specified Item with Value over £1000 incl. V.A.T) Value £
Specified Item with Value over £1000 incl. V.A.T) Value £
Specified Item with Value over £1000 incl. V.A.T) Value £
Specified Item with Value over £1000 incl. V.A.T) Value £
Caravan Details (give details if applicable):
Caravan Use
Type
Make
At Risk Address When Unused
Always Kept on a fixed Site
Serial Number
Chassis or Vin Number
Date Purchased Price Paid
Caravan Contents and Personal Effects
Caravan Contents Audio / Visual

Boat / Small Craft Detail (give details if applicable):
Type
Name
Sail Number
Class
Model / Make Date of Manufacture
Engine Details ( Type)
Engine Details (Make)
Engine Details (Serial Number)
Engine Details (Horse Power)
Engine Details (Date of Manufacture)
Maximum Speed of Boat / Craft
Is the Boat / Craft over 5 mtrs (or 16 ft 6 inches)
Do you want Insurance Cover for Boat / Craft + General Items
Do you want Insurance Cover for Outboard Motor
Do you want Insurance Cover for Road Trailer
Do you want Insurance Cover for Launching Trolley
Please Click Below 'Submit Button' to Send Form

 


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